Working with Ohio EPA during the COVID-19 pandemic.

Pretreatment Program Forms

Forms for Approved Programs

Annual Report Certification (Form 4117, 4221) [DOC]
- Annual Report Instructions
Recommended Detection Limits for Priority Pollutant Scans
Quarterly Industrial User Violation Report Certification (Form 4118) [DOC]
- Quarterly Report Instructions
Pretreatment Program Modification Request (Form 4115) [DOC]
- Modification Request Instructions

Quick Links

(Hint: Select an item and click "Go" to navigate)

Google Translate

Division of Surface Water
Phone: (614) 644-2001 ~ Fax: 644-2745 ~ Contact

Mailing Address: P.O. Box 1049, Columbus, OH 43216-1049
Street Address: 50 West Town Street, Suite 700, Columbus, OH 43215
Report a Spill, Release or Environmental Crime
(800) 282-9378 or (614) 224-0946

Working with Ohio EPA during the COVID-19 pandemic.

Pretreatment Program Forms

Forms for Approved Programs

PERMIT PROGRAMS

PERMITTING RESOURCES

Quick Links